Enalapril Enalaprilat Brand Name– Epaned | Vasotec
What is Enalapril Enalaprilat
Enalapril is an oral and parenteral angiotensin-converting enzyme (ACE) inhibitor used in the treatment of hypertension and congestive heart failure.
It has become a first-line agent for treating heart failure due to its proven reduction of mortality, and, in November 1993, it was approved for use in the early stages of heart failure to slow progression of the disease.
Enalapril is longer-acting than captopril but shorter-acting than other ACE inhibitors and is usually dosed twice daily when given orally. In some patients, once-daily dosing may be acceptable.
Neither enalapril nor enalaprilat contains a sulfhydryl group, which has implications regarding the drug’s adverse reaction profile. In general, ACE inhibitors appear to have a lesser effect on blood pressure in black patients (low renin population) than in non-black patients.
Enalapril was originally approved by the FDA in December 1985. Generic enalapril products became available in August 2000.
Indications
- diabetic nephropathy
- heart failure
- hypertension
- hypertensive emergency
- hypertensive urgency
- persistent albuminuria
- postmyocardial infarction
- proteinuria
Side Effects
- abdominal pain
- acute generalized exanthematous pustulosis (AGEP)
- agranulocytosis
- alopecia
- anaphylactoid reactions
- anemia
- angina
- angioedema
- anorexia
- anosmia
- arthralgia
- asthenia
- ataxia
- atrial fibrillation
- atrial tachycardia
- azotemia
- blurred vision
- bradycardia
- bronchospasm
- cardiac arrest
- chest pain (unspecified)
- cholestasis
- confusion
- conjunctivitis
- constipation
- cough
- depression
- diaphoresis
- diarrhea
- dizziness
- drowsiness
- dysesthesia
- dysgeusia
- dyspepsia
- dyspnea
- elevated hepatic enzymes
- eosinophilia
- eosinophilic pneumonia
- erythema multiforme
- exfoliative dermatitis
- fatigue
- fever
- flank pain
- flushing
- glomerulonephritis
- glossitis
- gynecomastia
- headache
- hemolytic anemia
- hepatic failure
- hepatic necrosis
- hepatitis
- hoarseness
- hyperbilirubinemia
- hyperkalemia
- hyponatremia
- hypotension
- ileus
- impotence (erectile dysfunction)
- insomnia
- jaundice
- leukocytosis
- melena
- muscle cramps
- myalgia
- myocardial infarction
- nausea
- neutropenia
- nightmares
- oliguria
- orthostatic hypotension
- palpitations
- pancreatitis
- paresthesias
- pemphigus
- peripheral neuropathy
- photosensitivity
- pruritus
- pulmonary edema
- pulmonary embolism
- rash
- renal failure (unspecified)
- renal tubular necrosis
- rhinorrhea
- Stevens-Johnson syndrome
- stomatitis
- stroke
- syncope
- teratogenesis
- thrombocytopenia
- tinnitus
- toxic epidermal necrolysis
- urticaria
- vasculitis
- vertigo
- vomiting
- xerophthalmia
- xerostomia
Monitoring Parameters
- blood pressure
- serum creatinine/BUN
- serum potassium
- serum sodium
Contraindications
- ACE-inhibitor induced angioedema
- Angiotensin-converting enzyme inhibitors (ACE inhibitors) hypersensitivity
- aortic stenosis
- autoimmune disease
- Black patients
- bone marrow suppression
- breast-feeding
- cardiomyopathy
- cerebrovascular disease
- collagen-vascular disease
- coronary artery disease
- dialysis
- geriatric
- heart failure
- hepatic disease
- hereditary angioedema
- history of angioedema
- hymenoptera venom (insect sting) allergy desensitization
- hyperkalemia
- hyponatremia
- hypotension
- hypovolemia
- immunosuppression
- infants
- jaundice
- low-density lipoprotein apheresis
- neonates
- pregnancy
- premature neonates
- renal artery stenosis
- renal disease
- renal failure
- renal impairment
- scleroderma
- surgery
- systemic lupus erythematosus (SLE)
Interactions
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Dichloralphenazone; Isometheptene
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Pseudoephedrine
- Acrivastine; Pseudoephedrine
- Aldesleukin, IL-2
- Alemtuzumab
- Aliskiren
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Aliskiren; Hydrochlorothiazide, HCTZ
- Aliskiren; Valsartan
- Alogliptin; Metformin
- Alpha-glucosidase Inhibitors
- Alprostadil
- Amifostine
- Amiloride
- Amiloride; Hydrochlorothiazide, HCTZ
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amobarbital
- Amphetamine; Dextroamphetamine Salts
- Amyl Nitrite
- Angiotensin II
- Angiotensin II receptor antagonists
- Apomorphine
- Apraclonidine
- Aprotinin
- Aripiprazole
- Asenapine
- Azathioprine
- Azilsartan
- Azilsartan; Chlorthalidone
- Baclofen
- Benzphetamine
- Bosentan
- Brexpiprazole
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Phenylephrine
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Cabergoline
- Calcium Phosphate, Supersaturated
- Canagliflozin; Metformin
- Candesartan
- Candesartan; Hydrochlorothiazide, HCTZ
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbidopa; Levodopa
- Carbidopa; Levodopa; Entacapone
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Cariprazine
- Carvedilol
- Cetirizine; Pseudoephedrine
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chlophedianol; Guaifenesin; Phenylephrine
- Chloroprocaine
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Clozapine
- Co-Enzyme Q10, Ubiquinone
- Cocaine
- Codeine; Phenylephrine; Promethazine
- Conivaptan
- Cyclophosphamide
- Cyclosporine
- Dapagliflozin; Metformin
- Desloratadine; Pseudoephedrine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexmethylphenidate
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Quinidine
- Diazoxide
- Diethylpropion
- Digoxin
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Phenylephrine
- Drospirenone
- Drospirenone; Estradiol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Duloxetine
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Enflurane
- Entecavir
- Ephedrine
- Eplerenone
- Eprosartan
- Eprosartan; Hydrochlorothiazide, HCTZ
- Ertugliflozin; Metformin
- Estradiol
- Estradiol Cypionate; Medroxyprogesterone
- Etomidate
- Everolimus
- Fexofenadine; Pseudoephedrine
- Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
- Fluorescein
- Fluoxetine; Olanzapine
- Fospropofol
- General anesthetics
- Glipizide; Metformin
- Glyburide; Metformin
- Gold
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guaifenesin; Phenylephrine
- Guaifenesin; Pseudoephedrine
- Haloperidol
- Halothane
- Heparin
- Hydralazine; Isosorbide Dinitrate, ISDN
- Hydrochlorothiazide, HCTZ; Irbesartan
- Hydrochlorothiazide, HCTZ; Losartan
- Hydrochlorothiazide, HCTZ; Olmesartan
- Hydrochlorothiazide, HCTZ; Spironolactone
- Hydrochlorothiazide, HCTZ; Telmisartan
- Hydrochlorothiazide, HCTZ; Triamterene
- Hydrochlorothiazide, HCTZ; Valsartan
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Ibritumomab Tiuxetan
- Ibuprofen; Pseudoephedrine
- Icatibant
- Iloperidone
- Iloprost
- Incretin Mimetics
- Indapamide
- Insulins
- Intravenous Lipid Emulsions
- Iohexol
- Iopamidol
- Iopromide
- Ioversol
- Irbesartan
- Iron Dextran
- Isocarboxazid
- Isoflurane
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Isoproterenol
- Isosorbide Dinitrate, ISDN
- Isosorbide Mononitrate
- Isosulfan Blue
- Kanamycin
- Ketamine
- Lanthanum Carbonate
- Levodopa
- Linagliptin; Metformin
- Lisdexamfetamine
- Lithium
- Loop diuretics
- Loratadine; Pseudoephedrine
- Losartan
- Lovastatin; Niacin
- Lurasidone
- Magnesium Salts
- Magnesium Sulfate; Potassium Sulfate; Sodium Sulfate
- Meglitinides
- Mestranol; Norethindrone
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methamphetamine
- Methohexital
- Methylphenidate
- Milrinone
- Naproxen; Pseudoephedrine
- Nateglinide
- Nebivolol; Valsartan
- Nefazodone
- Nesiritide, BNP
- Niacin, Niacinamide
- Niacin; Simvastatin
- Nitrates
- Nitroglycerin
- Nitroprusside
- Non-Ionic Contrast Media
- Nonsteroidal antiinflammatory drugs
- Olanzapine
- Olmesartan
- Oxymetazoline
- Paliperidone
- Pentoxifylline
- Phenelzine
- Phenylephrine
- Phenylephrine; Promethazine
- Polyethylene Glycol; Electrolytes
- Polyethylene Glycol; Electrolytes; Ascorbic Acid
- Potassium
- Potassium Phosphate
- Potassium Phosphate; Sodium Phosphate
- Pramlintide
- Prazosin
- Pregabalin
- Procainamide
- Procaine
- Propofol
- Pseudoephedrine
- Quinidine
- Rasagiline
- Repaglinide
- Rifampin
- Risperidone
- Sacubitril; Valsartan
- Salicylates
- Selegiline
- Sevoflurane
- SGLT2 Inhibitors
- Silodosin
- Sirolimus
- Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
- Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
- Spironolactone
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Sulfonylureas
- Tacrolimus
- Telavancin
- Telbivudine
- Telmisartan
- Temsirolimus
- Tetrabenazine
- Tetracaine
- Thiazide diuretics
- Thiazolidinediones
- Thiopental
- Thiothixene
- Tizanidine
- Tolvaptan
- Tranylcypromine
- Trazodone
- Triamterene
- Trimethoprim
- Valsartan
- Vasopressin, ADH
- Yohimbine
- Ziprasidone
